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  • Posterior hyaloid status on OCT could predict risk of fellow-eye retinal detachment

    Retina/Vitreous

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    Review of: Fellow-eye retinal detachment risk as stratified by hyaloid status on OCT

    Wallsh J, Langevin S, Kumar A, et al. Ophthalmology, in press 2023

    A 10-year retrospective review suggests that the presence of a completely detached posterior hyaloid in the fellow eye of patients presenting with a retinal detachment appears to be associated with a significantly lower risk of progression to bilateral retinal detachment.

    Study design

    This retrospective chart review of 1049 patients with a history of retinal detachment in 1 eye between May 2011 and January 2021 sought to determine the risk of subsequent detachment in the fellow eye. Posterior hyaloid status of the fellow eye (the presence or absence of a posterior vitreous detachment [PVD]) was determined using OCT imaging; other baseline characteristics such as the presence of lattice, refractive error, prior history of laser, lens status, and family history of retinal detachment were also obtained.

    Outcomes

    During a mean follow-up period of 5.7 years, 14.6% of patients developed bilateral sequential retinal detachment. Of the 582 fellow eyes with available OCT images at presentation, 60.7% showed an attached hyaloid. Only 3.1% of eyes that presented with a PVD progressed to retinal detachment during follow-up. Of those that developed a PVD during follow-up, nearly 24% had a retinal detachment as well, and 17.8% had a retinal tear that did not progress to retinal detachment.

    Limitations

    The retrospective nature of this study introduces limitations. There was also variability in the follow-up periods, and not all 1049 eyes underwent OCT imaging at the time of presentation.

    Clinical significance

    Using OCT to assess the posterior hyaloid status of the fellow eye at the time of retinal detachment appears to offer valuable information regarding the potential risk of subsequent retinal detachment. It is helpful to know that patients who present with a complete PVD likely have a lower risk of developing retinal detachment and tears in the fellow eye. I plan to obtain baseline macular OCTs in patients presenting with retinal detachment to better predict their risk of subsequent bilateral detachment.

    Financial Disclosures: Dr. Marianelli Rodriguez discloses no financial relationships.